Cough is a natural defence reflex which is important in airway clearance. Cough is the most common presentation in primary care and it can cause numerous complications including insomnia, urinary incontinence, ruptured blood vessels, fractured rib and vomiting.
Cough can be acute (duration of less than 3 weeks), subacute (duration of 3–8 weeks) or chronic (duration of greater than 8 weeks). Acute cough is usually caused by upper respiratory tract viral infections, subacute cough is often the residual cough after an infection has resolved and chronic cough can be due to a variety of medical conditions. These medical conditions can include upper airway cough syndrome, gastroesophageal reflux induced cough, cough-variant asthma and non-asthmatic eosinophilic bronchitis. Diagnosing is often through taking medical history, examining clinical symptoms, observing response to treatment, physical examination or diagnostic tests. Various treatment options are possible, depending on the nature of the cough and the underlying aetiology.
Expectorants, demulcents, antihistamines and non-opioid antitussives can be effective in treating cough, depending on the aetiology. Opioid antitussives are no longer recommended in treating cough. Prescription options such as corticosteroids, bronchodilators and leukotriene receptor antagonists are also possible treatment options available on prescription. Pharmacists can be involved in triaging patients, taking a thorough medical history, referring patients with warning signs and counselling patients on their treatment.
